On 1st January 2014, a little boy was rushed to hospital. He was seven months old at the time and had stopped breathing. The hospital examined him and found that he had bleeding inside his brain (what is called a subdural haematoma) and bleeding in his eyes (what are called retinal haemorrhages). Those things are commonly associated with a child having been shaken. Older readers may recall the trial of Louise Woodward, an English girl acting as a nanny in America, who was on trial for murder as a result of a baby who died with those presentations.
The hospital at the time made a diagnosis that the boy had suffered injuries to the brain as a result of having been shaken. The Local Authority issued care proceedings (very quickly) and the Court went on to hear the evidence and make the decision.
Re N (a minor) 2014
The issue in the case was quite simple (although the evidence involved in proving it is very complex)
1. Did this child stop breathing and mother then shook him (too hard) in an understandable attempt to revive him?
2. Did one of his parents pick him up and shake him, causing the injuries?
What happened in this case, when the finding of fact hearing took place, is that the lead medical expert wanted to know more detail about the parents evidence about the night in question, and having done so, gave his opinion that what they described was wholly consistent with explanation 1, which is what they said had happened.
At the end of the evidence, when the Local Authority were making their submissions, they indicated that they were in agreement that what had happened was version 1 – what the parents had said. The Judge told them that he agreed and that they were right to have accepted that.
At the outset of this fact-finding hearing the local authority invited the court to find that N had been the subject of an abusive non-accidental injury at the hands of one or other of his parents. Having listened to all of the evidence, in particular that of the Consultant Paediatrician Dr Cartlidge, I was told at the beginning of submissions this afternoon that the local authority had modified its position and now accepted that this was an ill-advised resuscitative shake by the mother of N in circumstances which I shall describe in a moment. I indicated that I wholly agreed with the assessment and conclusions of the local authority, and I applaud the local authority for taking the very realistic and sensible course that it has taken in this case
The Judge set out that the hospital were right to have acted as they did, and so were the Local Authority
Accordingly, whilst I in no way criticise the hospital for the approach that they took suspecting non-accidental injury, and in no way criticise the local authority for initiating the child protection procedures that it did making N the subject of a care application and placing him in foster care, I am entirely satisfied, particularly on the basis of the evidence of Dr Cartlidge but also on the basis of the evidence of the parents, that this was an accidental injury. The mother may have been ill-advised to shake, but she did it with no malicious intent, quite the reverse, she did it because she thought she was helping her son. Both the mother, with the benefit of hindsight, and the father in the course of their evidence said words to the effect that the mother may have over reacted in terms of the vigour with which she shook N. Given that I accept that this was a resuscitative shake, it is being too critical in my view to criticise the mother for failing to judge to a nicety that which she did in the extreme panic which I accept she was in at that time. So accordingly I find that N’s injuries resulted from an innocent but ill-advised resuscitative shake by his mother in the early hours of 1 January 2014
That innocent action, though it had terrible consequences for N, was not something that amounted to threshold, and so N would return home to his parents.
The reason why it is only happy(ish) rather than happy, is that the judgment on this case did not get delivered until the end of November 2014 (published today), and so N was living apart from his family for around eleven months whilst this all got sorted out. That seems a dreadfully long time. This is the other side of the coin in the 26 week debate – I grouse all the time about how 26 weeks can be unfair to parents, but if you were these parents, you would really want the case to be finished as soon as possible, because they did nothing wrong but had to live apart from their sick child until the Court could hear the evidence and the truth emerge.
It isn’t really clear from the judgment why it all took so long, but these cases are not easy to deal with. Experts have to be identified and to report, all the records have to be tracked down, where the case is in the High Court it can be difficult to find the time for long hearings. It all adds up.
I don’t know whether anyone has ever done follow-up studies on the impact of children on being apart from their family for this sort of length of time and then successfully rehabilitated. We tend to just walk away thinking of the happy outcome, but it must be really hard for everyone involved to adjust. This young boy of course now has life-altering consequences from his tragic injury, and that’s hard in itself; but you also have two parents who love him who missed out on 11 months of his 17 month life. Will that just repair itself, or will there be knock-on effects on the family for years to come?
I hope not, and I wish them all well.
I think this is a really good point but I think it goes beyond this case and into all situations where children are separated and then reunited (sometimes as a result of Care proceedings being withdrawn, sometimes when they are ‘rehabilitated’ to parents after CP have concluded and, very often in my experience, when they have been in Care for lengthy periods and voted with their feet and gone ‘home’ (back to birth parents) at 16 or sometimes before in the case of extremely persistent ‘absconders’.
In this case, it is clear from your explanation that parents have not been found to blame but it seems likely that they (and the child) will have suffered from some level of trauma due to what must have been a horrific experience from start to finish.
In relation to other less clear cut cases where children are separated from parents (often when they are older and have established attachments even if these are ‘barely adequate’ to use your helpful concept) I do have huge concerns that the impact of separation from the parent, on the child, is often glossed over, treated very simplistically or even missed out as a key piece of evidence, because (perhaps) it presents more of a problem to argue for permanent separation when the child is weeping at the end of every contact and constantly wanting to go home than when the child appears to have a less emotionally invested relationship with the parent.
I had hoped that the balancing of the relative ‘harms’ that I understood was now required would involve a situation where the ‘harm’ for the child of going back to parents would be carefully balanced against the risk of harm represented by (for example)putting a child with a clear (if not perfect) attachment to a parent and an expressed desire to go home, in foster care permanently. I would imagine anyone who has worked in this field for a while would know that this scenario would increase the risk factor of the child not making a secure attachment in foster care and of them taking matters into their own hands, breaking down placement after placement in an attempt to get ‘home’. We carefully consider risk of future harm in deciding whether to place back with parents but do we really balance the risk of future harm (especially for older children/teenagers) if placed in LA care, carefully enough?
I’m totally with you on this, a letter of apology (which is a rarity and something that has to be fought for) is all very nice.
But shouldn’t the Local Authority have a duty of care to everyone destroyed and pay for family therapy? The PTSD that inevitably follows removal is chronic, and presents in so many ways, usually with OCD thrown in to the mix, I’ve seen it over and over, I’ve even seen the Local Authority use the reactive depression they caused to keep children in LTFC or adoption
Older readers may recall the trial of Louise Woodward- RUDE!
I got called out on that yesterday by a friend. I did politely remind her that the Louise Woodward trial was 18 years ago….
I would accept a substitute of ‘my more vivacious readers may recall’
To my knowledge there has been no research focused on the issues relating to the short/medium/long-term effects of periods of (often long) separation prior to reunificaiton.
I have been involved with a significant number of such cases over quite a long period of time. From that perspective one of the most common issues following reunification (especially in injury-to-infants cases) is potential over protection – returned children being “bubble-wrapped” through fear that future normal accidents will be misconstrued as ‘abuse’ – and that the whole child protection nightmare will happen all over again.
A second crucial factor is the level of deleterious impact on the parent-child relationship from the separation, and how this has been affected by the level and context of parent-child contact during the period of separation. This is an area where there is significant arbitrary variations between cases. At the extremes, in similar situations, a parent may have contact only two or three times a week under close (unsupportive) supervision in an impoverished institutional environment. At the other extreme I have known cases where the parent has contact with the child for the child’s every waking moment in the foster home over seven days per week. Also, over seven days per week for several hours each time in a kinship care placement.
It is not difficult to imagine the difference that these two positions make to the parent-child relationship, and the level of repair required following reunification.
It remains very worrying that research such as that by Kenrick has been relied upon to promote the minimal level of contact model. See: http://www.peterdale.co.uk/wp-content/uploads/2011/08/ContactPaper2011.pdf
Both of those issues are really interesting, and I wonder whether someone will do some valuable follow-up research. I had in my mind, the second of those factors – the break in the attachment and how easy it is to repair, but the ‘bubble-wrap’ point is also significant, thank you Peter.
The published paper relating to my critique of the Kenrick research is:
Dale, P. (2013). Restrictions on natural parent contact with infants during care proceedings where forced adoption may be the outcome – some cautions about recent research and developing practice. Families, Relationships and Societies, 2,2,175-91.
Peter – I am very interested in the after effects of newborn removal, my child (“Baby B”) has now been referred by GP to CAMHS as a result of developmental delay. What I observed was a clear regression when returned to my care, behaving as a newborn, yet was several months old (Sorry to be vague – trying to protect identity). Would be very helpful for this issue to be looked in to and addressed.
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The triad is being disputed. It should not be held with the reliability of the Louise Woodward era. It is about time it is challenged more robustly. However challenge is not always allowed
Yes, there is much more medical doubt about shaking injuries and the degree of force involved (particularly whether it might be inadvertently caused) than there was at the time of the Louise Woodward trial. The Courts are much more sceptical about the Triad than they were even five years ago.
CML are also being disproven as only NAI. commonly seen in serial casting for talipes. Vit D not seen as a stand alone measure.the need to look further than basic testing. Mandatory checks on maternal antenatal health and post natal screening before NAI is even mentioned as a formal diagnosis. It will come clear soon but for how many too late lost children with no hope of return or them learning the truth. too many Experts unwilling to change will be the biggest hurdle. NAI theories 30 years old like a ‘snooky’ (my sons baby cuddle blanket)
It never repairs although you can learn to live with it. You can’t hit a rewind button once time passes you can’t get it back.
It’s hard to adjust to having a baby being taken then a toddler handed back.
If it’s your first child then you learn as the baby develops in normal circumstances and obviously you make innocent mistakes but in those circumstances especially when contact is supervised innocent mistakes are reported on and used against parents.
Contact supervisor logs should be signed off by parents. Some comments cannot be challenged later even if one of the parents was actually with their legal team at the time an ‘incident!” never challenged!
I hope you soon find some peace
They should be photocopied and handed to the parents before they leave